【摘要】 目的探讨基液细胞学检查(TCT)、高危型人类乳头状瘤病毒(HPV)检测联合阴道镜对宫颈癌筛查的临床价值。方法选择2003年1月～2006年6月到该院就诊的652例患者,包括宫颈炎、宫颈湿疣、阴道不规则流血流液等患者,均为已婚妇女,无子宫颈锥形切除或子宫切除病史,无盆腔放射治疗史,年龄在23～65岁,均做液基细胞学检查和人类乳头状瘤病毒DNA检测。对TCT检查为意义不明的不典型鳞状细胞(ASC-US)以上、HPVDNA检测阳性、宫颈细胞学检查阴性,但肉眼观察可疑病例共157例行阴道镜检查。结果652例患者中,TCT诊断宫颈异常细胞阳性率18.40%,组织学阳性率12.34%,两者比较差异无显著性;高危型HPV检测,PCR检出率21.01%,与TCT检出率(13.65%)相比差异有显著性(P<0.01)。联合阴道镜检查157例,拟诊CIN以上病变敏感性71.33%,特异性51.60%。结论TCT、高危型HPVDNA检测联合阴道镜可明显提高CIN的阳性检出率,降低漏诊率,是进行宫颈病变筛查的最佳方法,只有三者同时应用于癌前病变检查中,才能更好地发现宫颈癌前病变,阻断宫颈癌的发生。更多还原

【Abstract】 [Objective] To investigate the value of combining liquid-based thinlayer cytology test and high-risk human papillomavirus detection with colposcope in the screening of cervical carcinoma. [Methods] From January 2003 to June 2006, 653 married women with cervicitis, cervical condyloma, irregular vagina bleeding and discharge, aged from 23 to 65 years, no history of excisional cone cervix or hysterectomy, had liquid-based thinlayer cytology test (TCT) and human papillomavirus (HPV) detection to screen the cervical carcinoma, and 157 patients, who had atypical squamous cells of undetermined significance (ASC-US) and positive result of HPV DNA but negative result of cervical cytology test, were further examined by colposcope. [Results] Of all 652 patients, no significant difference in the positive rate of abnormal squamous identified by TCT (18.40%) and the positive rate identified by histology(12.34%) was found, and the significant difference between PCR detection(21.01%) and TCT detection(13.65) was found by high-risk human papillomavirus detection (P <0.01). 157 patients with combining colposcope were diagnosed CIN, and its sensibility was 71.33%, and specificity was 51.6%. [Conclusion] The combining of the liquid-based thinlayer cytology test and high-risk human papillomavirus detection with colposcope is the best way to increase the detection rate of CIN and decrease the rate of misdiagnosis, which can find the precancerous lesion and prevent it.更多还原